LONGMONT -- "Pay attention" is the message health insurance brokers are passing on to their clients this time of year.

October is always one of the busiest months for brokers as it's the most common time for "open enrollment" of health care plans for the upcoming year. Given that all deductibles are based on the calendar year, most companies opt for having their plans run Jan. 1 to Dec. 31.

Jan. 1 also will bring the next round of provisions kicking in for the Affordable Care Act, or Obamacare as it is sometimes known. As the calendar turns each year and more new rules kick in, employers are asking more and more questions about what the act means to them.

Claudia Maciuk, group benefits consultant with Volk & Bell Benefits, said at least half of her time with clients these days is spent explaining provisions of the health care reform law.

"From the employers' perspective, what I've seen from my clients is, they're just trying to understand what they're supposed to do," Maciuk said. "Compliance is a big issue right now -- just staying on top of what all the regulations are."

One example is the requirement for employers to provide their employees with a "Summary of Benefits and Coverage" form, a rule that just went into effect a week ago.

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Colorado already requires a similar form, called the Colorado Health Benefit Plan Description, so the federally mandated form is redundant, but employers now must fill out both, Maciuk said. And if they miss the deadline for the federal form? According to a federal document Volk & Bell provides its clients, there's a penalty of up to $1,000 for each "willful failure" to provide the SBC form. Plus, it can trigger an excise tax of $100 per day, per employee, for each day of noncompliance.

"We can guide them, we can educate them, but I have to explain it's the employer's responsibility," Maciuk said.

Added her boss, Clair Volk, president of Volk & Bell, "If there's going to be a fine, the employers going to have to pay it."

Theodore Poszywak, fire chief of the Frederick-Firestone Fire Protection District and a client of Volk & Bell, is responsible for choosing the health care plan for however many of his 35 full-time employees want to participate.

"So far, (compliance) hasn't been a huge burden that we've noticed, because they filter a lot of that out," Poszywak said. "Now, if we didn't have a broker? Then, yeah."

Kurt Mann, co-owner and business insurance specialist at First MainStreet Insurance, also consults clients on staying in compliance with the new law. If it seems complicated now, he said, just wait.

"They're just not aware of how ugly this is going to be," Mann said. "The reporting on this is ugly."

Pieces of the law are likely with U.S. forever

Versions of some of the measures of the Affordable Care Act that have already kicked in -- such as insurance companies not being allowed to deny coverage based on pre-existing conditions and parents being able to keep their kids on their plan until they are 26 -- were already in place in Colorado law, Maciuk said.

"We're much more progressive than some other states," she said.

Those two provisions are examples of why Maciuk and Volk think that whoever wins the November presidential election, at least certain pieces of the Affordable Care Act will remain in place, because of their popularity with the public.

Gov. Mitt Romney has pledged that if he is elected, he will repeal Obamacare on "day one."

"Even if Romney was elected, he can say that, but some of this is going to stay here," Maciuk said.

Mann agrees. But since he can't predict the future, he said when he holds open enrollment meetings with his clients, which he will be doing a lot of in the next few weeks, he simply works off the information he has in front of him.

"The vast majority of people in my industry, from the broker side to the carrier side, are moving forward as if this thing is going to exist as it is today," he said, adding, "I think it's highly unlikely any of this is going to be repealed. As a business owner who does this for a living, I'm not doing anybody any favors by holding off at all."

That said, it's not 2013 he's talking to his clients about. The changes kicking in this Jan. 1 are minor.

The big changes come in 2014, he said.

No appetite for going back

At the Frederick-Firestone Fire Protection District, health insurance costs have continued to rise while coverage has continued to shrink, Poszywak said. A few years ago, a 38 percent year-over-year jump in costs led him to switch carriers, and even since then he's still been seeing jumps of 15 percent to 25 percent.

"This year the (13.6 percent increase) was probably the lowest we've seen, and we're trying to figure out why," he said.

Maybe it's because of what Mann calls the "calm before the storm."

On Jan. 1, 2014, the biggest changes brought by the Affordable Health Care Act will kick into gear.

Those include, Mann said:

Mandatory coverage. If not covered under an employer's plan, individuals will need to either get insurance through a state-run insurance exchange or get it on their own, but they'll have to get it. Otherwise they'll pay a fine.

Employers will have to offer temporary employees who work an average of 30 hours per week health insurance coverage. With 835 full-time equivalent positions, and as an employer that uses many such "temporary" employees -- even though they may be employed on an extended basis -- that provision of the law is a big deal for the city of Longmont, according to Bobby King, the city's chief human resources officer.

"We're trying to get ahead of what might happen in 2014," King said. "What period constitutes a 30-hour average? Those guidelines aren't real clear right now.

"We're looking at it right now. People need to be thinking about that now and not wait for 2014."

In 2014, the so-called "Pay or Play" mandate kicks in. Employers need to either offer health care insurance to their employees at a certain level or pay a penalty -- a tax, in fact -- to the Internal Revenue Service.

Both Mann and Volk said that when it comes to all the provisions that kick in in 2014, that might have the most impact -- and might cause the biggest problems in terms of unintended consequences of the Affordable Care Act.

Some employers, Volk said, might just opt out of offering coverage altogether. They'll do the math and decide that paying the fine makes more sense for their bottom line than offering the coverage.

"Even if the government pays for part of it, some will say, 'I'm just going to drop out of it,'" he said.

So, will that lead to even more uninsured people? Or will the exchanges be able to absorb all those people?

And what if the individual mandate doesn't work, and people decide they'll just pay a fine rather than get insurance?

Those are among the million-odd questions the Affordable Care Act has raised, and continues to raise, as more pieces of the law are being implemented. The law itself, of course, was just a framework. The regulations that enforce provisions in the law are still being written, and will continue to be for the next few years.

No matter what happens at the ballot box this November, and for all its negatives, no one the Times-Call talked to for this story was ready to say the Affordable Care Act should be trashed completely and things be put back the way they were.

The Frederick-Firestone Fire Chief, Poszywak, notes that health insurance all by itself is 6 percent of his entire budget, so for his department, and his 35 employees, it's a big deal.

"Anytime the federal government or the state government passes down a law, it trickles down to small businesses," Poszywak said. "And that's what we are. We get our money from taxpayers, not by making widgets, but we're basically a small business.

"The health care system needs to be fixed. ... Something needs to be done. We can't continue to absorb 20 percent-plus increases as small businesses year after year."

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